Department of Orthopedics (Division of Plastic and Hand Surgery), The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Key Laboratory of Orthopedics of Zhejiang Province, The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China.
Department of Post Anaesthesia Care Unit, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China.
J Tissue Viability. 2021 May;30(2):276-281. doi: 10.1016/j.jtv.2020.12.007. Epub 2021 Jan 4.
Perforator flaps have been widely used in clinical Settings, however, unexpected necrosis was still commonly encountered in the distal portions of multiterritory flaps known as Choke zone III. In this study, we introduced a novel hybrid perfusion technique which is different from the established one of arterial supercharging or venous superdrainage to improve multiterritory flap survival with success. In order to ensure the entire flap survival of multiterritory flaps extending to choke zone III, a "hybrid perfusion" mode by anastomosing a distal vein of the flap with a recipient artery was carried out in two cases based on our previous basic study. In addition, a systematic literature review regarding the established microsurgical assistant techniques of arterial supercharging and venous superdrainage techniques were performed. Both flaps survived uneventfully. At a minimal follow-up of six months, both patients were satisfied with the results. This novel hybrid perfusion technique provides a simple new concept in solving partial necrosis of multiterritory flaps. Further practice is guaranteed for better understanding this unconventional attempt.
穿支皮瓣在临床应用中已得到广泛应用，但在多区域皮瓣的远侧部分（称为第三梗塞区）仍常发生意外坏死。在这项研究中，我们引入了一种新的混合灌注技术，与动脉加压或静脉超引流等已建立的技术不同，成功地提高了多区域皮瓣的成活率。为了确保延伸至第三梗塞区的多区域皮瓣的整个皮瓣存活，根据我们以前的基础研究，在两例患者中通过吻合皮瓣的远端静脉与受体动脉进行了“混合灌注”模式。此外，还对已建立的动脉加压和静脉超引流技术的显微外科辅助技术进行了系统的文献复习。两个皮瓣均未发生意外，顺利存活。在至少 6 个月的随访中，两名患者均对结果满意。这种新的混合灌注技术为解决多区域皮瓣的部分坏死提供了一个简单的新概念。进一步的实践将保证更好地理解这种非传统的尝试。
